March 29, 2007

Medical records of patients at the click of a button now in New Delhi

With the Municipal Corporation of Delhi ready to unveil its ambitious computerisation project interlinking some of its major hospitals, medical records of patients will now be available at the click of a button.

The Wipro HealthCare IT Limited and United Nations Children's Fund (UNCIEF)-assisted programme will make redundant bulky record-keeping, asking critically ill patients brought to the hospital for medical history and trying to track the exact treatment plan prescribed to patients.

"This is an ambitious project and under the programme we are interlinking our six major hospitals and healthcare institutes. Work started on the plan a couple of years ago and now we are ready to finally put the programme to use.

Under the programme, each patient will be issued a unique registration number and information will be added to his electronic folder. The information can be accessed at any of the interconnected hospitals by any treating doctor,'' said an MCD Health Department official.

The UNCIEF assistance is aimed at linking up birth records with immunisation records of children registered with the Capital's medical centres.

"The programme has connected Swami Dayanand, Infectious Diseases and Kasturba Gandhi hospitals among others. The programme is aimed at facilitating better and prompt treatment. We have already tested the programme and are now training 300 to 400 medical personnel to punch in and retrieve information as and when required. The project will also help researchers collect accurate health data that will act as a base for any further plans and projects proposed for the Capital,'' said MCD Chief Medical Officer (Health Informatics) R.C. Patnaik.

"To ensure that the programme runs smoothly, a nodal officer will be appointed in each hospital and training will be provided to persons who will have to use the programme. Computerisation of the hospitals will make work more streamlined and will benefit both the care providers and consumers."

March 26, 2007

Indian, Pakistan doctors join hands to set up medical centre

India and Pakistan have for the first time come together in the health and medical sector to set up an eye hospital.
Dr Daljit Singh, a renowned eye surgeon of India and Padma Shree awardee, laid the foundation stone of the ‘Nankana Medical Complex’ at Nankana Sahib, the birthplace of Guru Nanak in Pakistan, recently.
Revealing this to mediaperson after his return from Pakistan, Dr Singh said the medical complex would have an ultra modern eye care centre. The it would be a befitting tribute to Guru Nanak Dev, the founder of Sikh religion, he added.
‘‘This is perhaps for the first time that a collaboration between the medical experts of India and Pakistan has taken place and a venture of such mammoth proportion has been set up to offer low cost medical facilities in Pakistan,’’ he said.
Dr Singh said his team of doctors including Dr Ravijit Singh, Dr Indu R Singh , Dr Seema and Dr Kiranjit Singh were applying for multiple and all-time visas to Pakistan so that they may be able to perform surgeries, disseminate latest techniques and mobilise eye surgeons within Pakistan to offer services at nominal cost to their people.
Besides, his hospital here would also try to promote availability of equipment, materials and machines to the medical complex at Nankana Sahib, he added.
The complex has been sponsored and executed by the Pakistan Eye Foundation headed by Prof T H Kirmani, president of SAARC foundation, on one acre land.
Under the agreement between the doctors of both countries, there would be an exchange of experts and technical manpower. Strengthening existing training programmes in Pakistan would be his endeavour, Dr Singh said.

March 21, 2007

USA Hospitals go green

Hospitals in the United States are beginning to recognize that the health of people is interlinked with the health of the surrounding community and the environment at large.

Health care officials are adopting a progressively ecological approach, reports say. They are doing away with incinerators, procuring safer construction materials and serving up healthier food for patients.

According to the Centers for Disease Control, chronic diseases and conditions now affect more than one third of the US population.

In spite of medical advancements, scientific evidence shows an increase in asthma, autism, learning disabilities, birth defects, childhood brain cancer, endometriosis and other chronic conditions linked to toxic pollutants, notes Stacy Malkan.

He is the communications director for Health Care Without Harm, a coalition of 450 groups in 55 countries working to transform the health care industry.

The campaign of such advocacy groups seems to have had some positive impact.

In 1995, for example, medical waste incinerators were the number-one source of dioxin, a most potent carcinogen, cancer-causing chemical.

The US Environmental Protection Agency had warned that incinerators were responsible for 10 percent of mercury emissions.

But now a decade later, more than 5,000 medical waste incinerators have closed down in the US. Fewer than 100 remain. Thousands of hospitals are phasing out products that contain mercury.

Or take the case of PVC or vinyl extensively used in construction industry. It also produces dioxin. It is toxic throughout its lifecycle. Now more and more hospitals are opting for PVC-free carpets and wall-coverings.

March 18, 2007

Six more AIIMS like centres coming up

The Indian government proposes to set up quality hospitals on the model of the All India Institute of Medical Sciences, New Delhi, in Patna, Raipur, Bhopal, Bhubaneshwar, Jodhpur and Rishikesh under the Pradhan Mantri Swastha Sureksha Yojna (PMSSY), Union Minister for Health and Family Welfare Anbumani Ramadoss has said.

In a written reply to questions raised by some members of the Rajya Sabha, the upper House of the Indian parliament, the minister said that these new hospitals would come up within the next four years.

The AIIMS, New Delhi was set up in 1956 to serve as a nucleus for nurturing excellence in all aspects of health care. The Institute has comprehensive facilities for teaching, research and patient-care.

At the moment there is a heavy influx of patients into the AIIMS, particularly from the northern states. Specialty treatments like cancer care, burns care, brain surgery, plastic surgery and the like are not available in the northern and eastern parts of India.

Minister Ramadoss hoped that the new hospitals would significantly reduce the pressure on the New Delhi institute.

Besides thirteen existing medical institutions have been identified for upgradation to the level of the AIIMS, the minister added.

In reply to another query, he said the report of the M.S.Valiathan committee that studied the functioning of the New Delhi AIIMS was under the consideration of the government Ramadoss also affirmed that the government was committed to increasing expenditure in health sector from the current level of 0.9 per cent of the GDP to 2-3 per cent of the GDP over the next five years.

Reverse Brain Drain of Doctors

Many foreign and NRI doctors are now making a beeline for India and wanting to relocate here to gain the India experience. AHS claims it is getting enquiries from foreign doctors in the US and EU who want to visit the facility and then take a final decision on India.

Tehrani had never imagined that one day he would be assisting in setting up a hospital in India. "Initially, I was sceptical, but a couple of trips later, I saw it as a lifetime opportunity. And my mind was made up," he says. Of course, his wife, a doctor herself too saw it as a great opportunity and challenge.

He realised that if he stayed on in the US, he would be doing the same kind of work even after a decade. It didn't challenge him anymore. "There was little room for personal growth. I wanted to do much more than just treating patients," he asserts. He feels India could offer him that challenge. "The sheer number of patients and cases one handles here is in itself a challenge," says Tehrani.

The situation is much the same in other hospitals too. Dr Shabnam Singh who handles physician recruitment at Max Healthcare, says,"We get many enquiries from foreign doctors who are interested in coming to India. In fact, one of our ads for a surgeon had 20% non-Indian applicants." In fact, in the last three months, a senior NRI dentist, a plastic surgeon and a cardio-vascular surgeon have joined the hospital.

This reverse brain-drain began in the the last five years when many NRI doctors came back by choice. Singh says 10% doctors at Max Healthcare are such cases. For decades, India had watched many of its best-educated doctors shift abroad in search of degrees and mega bucks, never to come back. But now, with talent returning to India, the implications for a developing country like ours is potentially huge.

Dr Vivek Raj, a gastroenterologist with Max Healthcare, says doctors return for both personal and professional reasons. He himself came back in June to join Max after spending 18 years in the US. And despite doing quite well at the University of Arkansas, Little Rock, he began to feel bored like Tehrani. "For the last three years, I wanted to come back as I couldn't imagine doing the same thing for years together. Also, I wanted to translate what I had learnt abroad here."

Though there are the usual explanations about wanting to return to their roots, be close to aging parents and wanting kids to imbibe Indian values, there are other reasons for the prodigals returning. Read the rest of the Story on Times of India Website

March 14, 2007

Medical PGs from foreign varsities can practice in India

In a significant move, the Centre today informed the Supreme Court that Indian post graduate medical students, who obtained degrees from foreign universities, will be permitted to practice in the country after a screening test.

Additional Solicitor General Gopal Subramaniam appearing for the Centre told a bench of Justices B N Agrawal and P P Naolekar that such a concession would, however, be a one-time benefit and subject to the new set of regulations being framed by the government.

According to Subramaniam the government had decided to grant such time concession on humanitarian grounds after consulting the Medical Council of India (MCI).

The government's latest assurance is bound to gladen hundreds of post graduate medical students and those pursuing the super speciality courses from foreign universities particularly from countries like Russia, Switzerland and other countries.

Under the existing policy, only undergraduate medical students, who have obtained their degrees from foreign universities, are entitled to practice in India after they clear the mandatory screening test conducted by the Medical Council of India (MCI).

However, no such concession is available to those pursuing postgraduate and super speciality courses as they are barred from practising in India.

Free genetic testing to begin in Chandigarh hospitals

All government hospitals in Chandigarh will offer the facility of mass screening to pregnant mothers and newborns so that genetic disorders can be detected early, the UT Administration has decided.

UT officials were very proud to announce that Chandigarh will be the first city in India to offer such mass screening at government hospitals and nursing homes.

After the successful trial conducted at Genetic Centre, Government Medical College Hospital (GMCH), the facility has been extended to all other government hospitals, including Multispeciality Hospital, Polyclinic, Sector 22, and other Government Nursing Homes under the Administration.

Earlier, the Administration had decided to initiate neo-natal screening of all children at the Genetic Centre, GMCH. Soon, the Government Multispecialty Hospital and others followed suit. This was done to work out various logistics and requirements before the decision was taken to extend the facility to pregnant mothers and newborns across the city.

The Genetic Centre in GMCH started pre-natal screening to find out how many pregnant women were at high risk.

Hundred and five pregnant women were screened and five were found high risk on the genetic disorder scale.

As equipment and infrastructure in the trial run could sustain tests for more than a month without a glitch, facilities for pre-natal screening have been extended to other hospitals.

The procedure and logistics for neo-natal screening are being worked out and the UT Administration intends to start the neo-natal mass screening programme shortly.

March 12, 2007

Self-propelled medical trains to come to rescue

The medical train used by Railways to cater to those injured in rail accidents will soon be upgraded. To reduce the time taken for this train to reach the place of accident, Railways is planning to introduce self-propelled trains.

“In a self-propelled train, there is no need to attach the engine to the coaches. After intimation about any mishap is made through a hooter, the engine is attached to the coach and this is a time-consuming process,” said a doctor from Railways Hospital Unit, adding, “But in this train, a driver can come and simply start and take the train to the spot.”

At the moment, this train has a well-equipped operation theatre with surgical equipment, emergency medicines and arrangement of light for electricity supply. There is one bogey in th medical train that has around ten berths or beds for patients, blankets and bedsheets. Tents are also available in these trains in case of emergency and if required, the doctors can set-up a mini hospital.

Around 20 coffins have been provided in these trains. The health care unit at the station has a staff of 25 doctors.

The generators have been provided so that there is no inconvenience and surgeries and treatments are carried out smoothly, the train also has a mini-kitchen to look after the needs of doctors.

Indian National Mental Health Act need to reviewed

Speaking on the occasion of inaugural programme of International Women's Day and the seminar on "Mentally Ill Women - is Destitution the only Answer?" in New Delhi, the Indian Minister for Health & Family Welfare, Dr. Anbumani Ramadoss said that mentally ill women face formidable socio-economic problems such as neglect by family and society, dislocation, abandonment and are vulnerable as easy targets of sexual abuse.

There is an urgent need to study the issues concerned with such mentally disadvantaged women focusing on social, legal and ethical aspects. The critical gap in the need, availability and accessibility of mental health care services needs to be corrected.

"This is a very sensitive subject needing deliberations to ease the problems of mentally ill women. Indeed, mental health is one of the main dimensions of health and aptly said there could be no health without mental health.

Research has demonstrated whether it is denial of economic resources, education, legal and health services deprivation, lack of physical and mental nurturance, exhaustion from overwork or se xual and other forms of physical and mental abuse across the life span, research corroborates that it is women who are at the greatest risk. These issues not only fall within the fabric of human rights, but also are those, which understandably affect mental health.

Mental health may be defined as the capacity of individuals and groups to interact with one another and the environment in ways that promote subjective well-being, optimal development, and use of cognitive, affective and relational abilities. It is much more than the absence of mental illness. It is the realization of one's potential shaped by factors such as biological make-up, gender roles, family life, human relationships, work opportunities, educational achievements, and a variety of structural and socio economic determinants.

People suffering from mental illness and other mental health problems are among the most stigmatized, discriminated against, marginalized, disadvantaged and vulnerable members of society.

With inadequate support and a strong gender bias, the mentally ill women are rarely accepted into the family and are forced to fend for themselves resulting in homelessness. Mental illness may play a role in initiating homelessness for some. A combination of severe mental illness, a tendency to decompensate in a non structured environment, and an inability or unwillingness to follow through with aftercare contributes to their being involved with the criminal justice system.

Perceiving the magnitude of the problem in India, some Government and Non-Government Organizations like Banyan, Institute of Human Behaviour and Allied Sciences (IHBAS), Action Aid India, National Institute of Mental Health & Neuro Sciences, Bangalore (NIMHANS) etc. are mobilizing their services to help women with mental illness particularly those who are underprivileged."

March 11, 2007

Health insurance set to become more affordable

There are no major surprises for the insurance industry in this year’s Budget. The only exception being that health insurance is set to become more affordable with increased tax breaks. It will also become more accessible to senior citizens, with new products being structured for them.

For instance, as against the present tax exemption limit of Rs 10,000 (under Section 80D of the Income Tax Act set 20 years ago), health insurance premium up to Rs 15,000 will now be eligible for exemption.

This means that you can ensure higher medical cover for yourself and your family while simultaneously saving more tax. According to experts, the move is bound to be welcomed by middle-class taxpayers who are unwilling to put up with pathetic facilities in most government hospitals and are intimidated by the heavy bills that accompany treatment in good private hospitals.

Depending on age, a payment of Rs 15,000 can earn a medical cover of up to Rs 5 lakh each for a family of husband, wife and two children.

For senior citizens, the exemption limit is even higher at Rs 20,000 — a much-needed move given the almost total absence of an effective social security system. At the same time, the hike in investment limit will benefit insurance firms by triggering an increase in demand for mediclaim policies.

There’s an added benefit for consumers: policies had become costlier since public sector insurance majors found they were paying large amounts on claims compared with sales. Following the tax sops, policies may now get cheaper.

Cell phones safe to use in hospitals: U.S. study

Calls made on cell phones do not affect hospital medical devices, U.S. researchers said on Friday, but store anti-theft alarms might make implanted heart devices misfire.

Tests at the Mayo Clinic in Rochester, Minnesota showed normal use of cell phones, also called mobile phones, caused no noticeable interference with patient care equipment, they said.

But a portable CD player caused an abnormal electrocardiographic (ECG) reading when a patient used it near one of the leads of the device, according to one of several reports in the March issue of Mayo Clinic Proceedings.

Most hospitals forbid the use of cell phones.Dr. David Hayes and colleagues said their tests suggest the ban is unmerited. They tested cell phones using two different technologies from different carriers, switching them on near 192 different medical devices. 300 tests run over five months, they reported no trouble with the equipment.

March 09, 2007

Medical reports can be disclosed under RTI

The State Information Commission has ruled that the medical reports of former Maharashtra Minister Surup Singh Naik when he was in state-run J J hospital during his one-month prison term can be disclosed under the Right to Information Act.

Social activist Shailesh Gandhi had applied to the hospital in May last year, seeking Naik's medical records. Naik, the former Forest Minister, was sentenced to one month's imprisonment by the Supreme Court last year for defying its orders to close down illegal saw mills.

But he immediately got himself admitted to J J Hospital after complaining of chest pain, and spent most of the sentence there.

Gandhi's request to J J Hospital's public information officer under the RTI to obtain Naik's medical reports was denied. He then filed an appeal before Chief Information Commissioner Suresh Joshi.

Joshi heard the matter and referred it to a four-member bench comprising himself and three other information commissioners. The bench yesterday decided that the information should be revealed.

Authorities at J J Hospital have been ordered to give the relevant information within seven days.

March 06, 2007

Apollo, 20 others to set up hospitals in UK

A large number of private hospital groups and healthcare companies in the country are all set to set up their units in the UK.

The reason: There is an increasing demand for healthcare facilities in UK, which the present infrastructure cannot provide.

The Apollo Hospital Group which has its own units in Kolkata, Delhi, Chennai and other cities in the country has already got a green signal from the UK government to set up a hospital in London.

Parminder Sunda, sector manager, Asia (health care) of UK Trade and Investment, said, "The National Health Service (NHS) in the UK controls the healthcare system since the inception of the organisation in 1948. The NHS is now suffering from excessive long wait lists causing patients backlogs and prolonged waits in hospitals.

"Every patient now has waits six to eight hours every day to get treatment in the hospitals. We want to bring down the waiting period to two hours on an average by 2010."

Sunda along with six other delegates have come to Kolkata to explore trade investment in healthcare services in India. They will tour several other cities like Delhi and Chennai to find out opportunities in partnerships in healthcare services.

Sunda while talking to reporters during an inter-active session on Indo-UK healthcare seminar said, "About 20 private hospital groups Apollo Hospital Group, Escorts-Fortis Hospital and a Mumbai-based hospital have already approached the UK government to set up their branches in UK. The Apollo Hospital Group is reported to be talking to some other private hospital as potential takeover under the NHS."

Many Indian medical technology companies are also approaching the UK government for exporting medical equipment and machineries. More than 50 small and medium companies have shown interest in the fields arterial surgery, invitro-diagnostics and orthopaedics and others, one of the delegates said.

Kevin McCole, deputy head of British Deputy High Commission, Kolkata, said that the UK government is very much interested in public private partnership (PPP) ventures in healthcare services. Talks are on between the two countries.

March 04, 2007

More Indian Doctors head to the US

In a sixties phenomenon that is making a comeback, Indian doctors are again heading for American shores. Thanks to scarce MD seats — made even more scarce by reservation — doctors are again queuing up outside the offices of visa consultants.

India produces 30,000 MBBS graduates every year, But less than 50% of these students get a MD seat. There are too many MBBS doctors and too few MD seats, leading to a funnel-like situation. So many doctors have no option but to go abroad.

The USMLE is a three-stage process. Step 1 and Step 2-CK (clinical knowledge) exams can be taken in India while Step 2-CS (clinical skills) has to be taken in the US.

But it's still easier for an IT professional to get to the US on a H-1B visa than a doctor who has cracked the USMLE. Most doctors initially go on a J1 (exchange visitor) visa.

Under this category, doctors have to abide by a two-year foreign residency (in this case, the home country) rule after completing their MD and fellowship programme. They can avoid foreign residency by opting for a waiver job i.e. working in an under-privileged district in the US for two years.

After that, doctors must find universities or hospitals who are willing to sponsor them under a H-1B category. Only a lucky few manage to bag a H-1B sponsor offer after clearing Step 3 of the USMLE.

So while many IT professionals manage to get permanent residency at the end of their six-year H-1B visa tenure, for doctors the wait for a green card can stretch almost 10 years.

Another category of students eying residency programmes in the US are Indians who have got their MBBS degrees from Russia or other East European countries. To be a qualified practitioner in India, such doctors have to pass a few more examinations conducted by the Medical Council of India (MCI). In such a scenario, many of these doctors end up exploring options abroad.

For some, it's the sheer choice of specialities that's a draw. Arati Pradhan wants to specialise in geriatrics after her MBBS degree. "Only a couple of institutes in India offer a programme in geriatics while in the US, there is no dearth of universities offering the programme. I stand a better chance there," says Pradhan.

Options apart, the lure of the dollars isn't easy to pass up. Doctors who go to the US on a residency get an average annual stipend of between $40,000 and $50,000. Moreover, on completion of the residency and fellowship programmes (which last from three to seven years), medical practitioners are ensured of good pay packets if they decide to opt for private service.

Besides, there is the work environment and the promise of doing path-breaking research in laboratories that drives some of the country's best medical minds abroad.

Points out Dr Pradeep Muley, senior consultant, interventional radiologist, Batra Hospital & Medical Research Centre, "Many hospitals in the US have full-fledged research departments with budgets and good funding. Moreover, the hospital chips in with more funds if any particular research work shows signs of promise."

A couple of years back, US authorities refused to give visas to doctors but now they have relaxed their norms. In any case, the system in US is reasonably open and many non-American doctors who have gone there have done well for themselves.

March 01, 2007

Union Budget: Health outlay hiked by 21.9% to Rs.152.91 billion

The health sector in India is set to get a major boost in 2007-08 with the central budget Wednesday proposing a 21.9 percent increase in health expenditure outlay to Rs.152.91 billion.

In the second phase of the Integrated Child Development Services (ICDS), the budget has sanctioned 173 ICDS projects, 107,274 anganwadi (mother and child) centres, and 25,961 mini-anganwadi centres, Finance Minister P. Chidambaram stated in parliament.

The budget has increased the outlay for ICDS from Rs.40.87 billion in 2006-07 to Rs.47.61 billion in 2007-08.

'Government is committed to expand the scheme in order to cover all habitations and settlements, during the Eleventh Plan and to reach out to pregnant women, lactating mothers and all children below the age of six,' he said.

Elaborating, he said 320,000 associated social health activists (ASHAs) have been recruited and 200,000 have received orientation training.

Besides, 90,000 link workers have been selected by the states. 'I am confident that there will be significant improvement in healthcare in rural areas,' the minister said, adding that allocation for the National Rural Health Mission (NRHM) had gone up from Rs.82.07 billion in 2006-07 to Rs.99.47 billion in 2007-08.

Expressing concern over the surge of polio in 2006, the minister said there would be intensive coverage in 20 high-risk districts of Uttar Pradesh and 10 districts of Bihar.

'ASHA and Anganwadi workers will visit every single household and track every single child for the immunisation programme,' he said.

Chidambaram promised that his government would undertake determined efforts to achieve zero level of growth in HIV/AIDS. Under the renewed effort, the National AIDS Control Programme III (NACP-III) starting 2007-08 would target high-risk groups in all states.

Union Budget: More funds for rural health mission

The government's flagship National Rural Health Mission (NRHM) has got increased allocation in the central budget for 2007-08 with major emphasis on mother and child care and prevention of communicable diseases.

Traditional healing systems like aurveda, yoga, naturopathy, unani, sidha and homeopathy are being mainstreamed into the health delivery system at all levels.

Presenting the budget in parliament, Finance Minister P. Chidambaram said there would be major emphasis on mother and child care and prevention of communicable diseases like tuberculosis and malaria and to fund these projects he had increased the allocation from Rs.82.07 billion in 2006-07 to Rs.99.47 billion in 2007-08.

Polio, which witnessed a surge in 2006 with 666 cases, has also been integrated with the NRHM and Rs.12.90 billion has been allocated to eliminate the disease.

Chidambaram also promised that his government would undertake determined efforts to achieve zero level of growth in HIV/AIDS.

Under the renewed effort, the National AIDS Control Programme - III (NACP-III), starting 2007-08, would target the high-risk groups in all states. The minister proposed to step up the provision for the AIDS control programme to Rs.9.69 billion.

The minister also emphasised that more hospitals would provide treatment to prevent the transmission of HIV/AIDS from mother to child.

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